主动脉内球囊反搏联合血栓抽吸术治疗大面积ST段抬高型急性心肌梗死的疗效观察

Therapeutic Effect of Intra Aortic Balloon Counterpulsation Combined with Thrombotic Aspiration in the Treatment of Large Area ST Segment Elevation Acute Myocardial Infarction

目的研究主动脉内球囊反搏联合血栓抽吸术对大面积ST段抬高型急性心肌梗死患者心功能及预后的影响,观察其临床疗效。方法选取2016年5月~2017年1月我院大面积ST段抬高型急性心肌梗死患者80例,按照随机抽签方式分为对照组和观察组,各40例。对照组采取予以血栓抽吸术治疗,观察组予以主动脉内球囊反搏联合血栓抽吸术治疗,比较两组术后肺动脉楔压(PCWP)、心输出量(CO)、平均动脉压(MABP)、心肌钙蛋白(CTn I)峰值及肌酸激酶同工酶(CK-MB)峰值水平及心功能改善情况。结果观察组CO高于对照组,差异有统计学意义(P<0.05);观察组MABP高于对照组[(55.38±10.76)mm Hg vs(42.79±11.08)mm Hg],差异有统计学意义(P<0.05);观察组PCWP低于对照组[(9.41±6.65)mm Hg vs(18.33±7.56)mm Hg],差异有统计学意义(P<0.05);CTn I及CK-MB峰值水平观察组均低于对照组[(0.34±0.06)μg/L vs(0.51±0.15)μg/L、(105.19±10.78)U/L vs(151.64±15.72)U/L],差异有统计学意义(P<0.05);术后6个月观察组LVEF优于对照组[(43.27±6.37)%vs(39.85±5.96)%],差异有统计学意义(P<0.05);术后6个月观察组LVESD、LVEDD水平均低于对照组,差异有统计学意义(P<0.05)。结论与血栓抽吸术相比,主动脉内球囊反搏联合血栓抽吸术可进一步改善患者心功能,且预后良好,值得临床应用。

Objective To study the effects of intra-aortic balloon counterpulsation combined with thrombotic aspiration on cardiac function and prognosis in patients with large ST segment elevation acute myocardial infarction.Methods 80 patients with large area ST segment elevation acute myocardial infarction from May 2016 to January 2017 were randomly divided into control group and observation group with 40 cases each.The control group was treated with thrombotic aspiration,and the observation group was treated with intraaortic balloon pump combined with thrombotic aspiration.The peak values of pulmonary wedge pressure(PCWP),cardiac output(CO),mean arterial blood pressure(MABP),cardiac troponin I(CTnI),creatine kinase isoenzyme(CK-MB)and cardiac function were compared between the two groups.Results The observation group CO was higher than the control group,the difference was statistically significant(P<0.05);the observation group MABP was higher than the control group[(55.38±10.76)mmHg vs(42.79±11.08)mmHg],the difference was statistically significant(P<0.05);PCWP in observation group was lower than that in control group[(9.41±6.65)mmHg vs(18.33±7.56)mmHg],the difference was statistically significant(P<0.05);The peak levels of CTnI and CK-MB were lower in the observation group than in the control group[(0.34±0.06)μg/L vs(0.51±0.15)μg/L,(105.19±10.78)U/Lvs(151.64±15.72)U/L],the difference was statistically significant(P<0.05);LVEF in the observation group was better than that in the control group[(43.27±6.37)%vs(39.85±5.96)%]at 6 months postoperatively,and the difference was statistically significant(P<0.05).The level of LVESD and LVEDD in the observation group was lower than that in the control group at 6 months after operation,the difference was statistically significant(P<0.05).Conclusion Compared with thrombotic aspiration,intra-aortic balloon counterpulsation combined with thrombotic aspiration can further improve the cardiac function of the patients,and the prognosis is good,which is worthy of clinical application.